Bilateral Severe Herpes Simplex Endotheliitis with a Possible Association with Latanoprost

ABSTRACT

Purpose

To report bilateral Herpes Simplex virus (HSV) keratitis in a patient on latanoprost for primi]k=8ary open angle glaucoma (POAG).

Methods

Case report.

Results

A 76-year-old healthy male on latanoprost monotherapy for POAG polresented with sudden bilateral decreased vision. Examination showed bilateral dense corneal edema with loose epithelium. Aqueous fluid was positive for HSV-1 DNA on polymerase chain reaction (PCR). Latanoprost was discontinued, topical prednisolone acetate 1% eye, acyclovir 400 mg 5 times a day and combination of dorzolamide hydrochloride 2% and timolol maleate 0.5% twice daily were prescribed. The vision rapidly improved to 20/25 along with complete resolution of corneal edema within four weeks, with no recurrences over the next one year.

Conclusion

Bilateral simultaneous HSV endotheliitis is a rare condition and positive PCR test can help rule in the diagnosis. HSV keratitis is a known adverse event with Latanoprost use and can present atypically.

KEYWORDS:

• Bilateral HSV endotheliitis
• corneal edema
• endotheliitis
• herpes simplex virus keratitis
• latanoprost adverse effects

Consent to publish statement

The authors confirm that the consent to publish has been obtained from the patient.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Additional information

Funding

This work was funded by Hyderabad Eye Research Foundation, Hyderabad [Grant No: LEC -BHR -R-10-21-769].